Aa
Hiv question
Hi, I had unprotected anal intercourse with a ladyboy ( i think) around 3 weeks ago)
I have had 2 rapid hiv tests (1 at 2 weeks) and (1 at 3 weeks) , both negative.
Although after 2 weeks i developed a UTI... Burning sensation when urinating, but no other symptoms like puss/discharge, itch etc.... I took doxcycline,,, and cephalexin and just as it seemed to clear up and almost go completely,,, I started having light fevers that lasted a couple of days but am still having very bad night sweats and also painful lumps under my arms. i cannot work out whether these are spots under my arms or swollen lymph nodes... 1-they are v tender and painful,,,2-1 is in my left armpit-stopped hurting and almost went within 2 days of appearing.. the other is in actually at the very top undermath of my right arm (almost in my armpit but still on my arm)... The question is doctor--- are HIV lymph nodes painful like this? would i get night sweats as a sign of acute hiv infection or are these symptoms more logically a result of the UTI..
I have had 2 rapid hiv tests (1 at 2 weeks) and (1 at 3 weeks) , both negative.
Although after 2 weeks i developed a UTI... Burning sensation when urinating, but no other symptoms like puss/discharge, itch etc.... I took doxcycline,,, and cephalexin and just as it seemed to clear up and almost go completely,,, I started having light fevers that lasted a couple of days but am still having very bad night sweats and also painful lumps under my arms. i cannot work out whether these are spots under my arms or swollen lymph nodes... 1-they are v tender and painful,,,2-1 is in my left armpit-stopped hurting and almost went within 2 days of appearing.. the other is in actually at the very top undermath of my right arm (almost in my armpit but still on my arm)... The question is doctor--- are HIV lymph nodes painful like this? would i get night sweats as a sign of acute hiv infection or are these symptoms more logically a result of the UTI..
The law as you put it also states that 4th generation tests have shorter window periods.Many Hiv experts will confirm this.
Dr. Jose Gonzalez-Garcia, MD, MBBS, LMS, MRCP(UK), MRCGP, PhD
. The negative test that you had at 8 weeks is certainly highly reassuring and a very good indication as it is possible to detect the HIV antibodies already at that stage. However current UK guidelines still recommend to have a final test at 12 weeks for it to be considered final and fully conclusive.
Dr José
. The negative test that you had at 8 weeks is certainly highly reassuring and a very good indication as it is possible to detect the HIV antibodies already at that stage. However current UK guidelines still recommend to have a final test at 12 weeks for it to be considered final and fully conclusive.
Dr José
I can't help that you cannot except the facts.
http://www.cdc.gov/globalaids/Resources/pmtct-care/docs/TM/Module_6TM.pdf
Page 11
#4
In an adult, a positive HIV antibody test result means that the person is infected, a person with a negative or inconclusive result may be in the “window for 4 to 6 weeks but occasionally up to 3 months after HIV exposure. Persons at high risk who initially test negative should be retested 3 months after exposure to confirm results
UK Fourth Generation Testing
http://www.bhiva.org/documents/Guidelines/Testing/GlinesHIVTest08.pdf
Post testing
Page 11
The need for a repeat HIV test if still within the window period after a specific exposure should be discussed. Although fourth generation tests shorten the time from exposure to seroconversion a repeat test at three months is still recommended to definitively exclude HIV infection.
There are no tests marketed or sold that can give a conclusive test earlier than 3 months post exposure.
http://www.cdc.gov/globalaids/Resources/pmtct-care/docs/TM/Module_6TM.pdf
Page 11
#4
In an adult, a positive HIV antibody test result means that the person is infected, a person with a negative or inconclusive result may be in the “window for 4 to 6 weeks but occasionally up to 3 months after HIV exposure. Persons at high risk who initially test negative should be retested 3 months after exposure to confirm results
UK Fourth Generation Testing
http://www.bhiva.org/documents/Guidelines/Testing/GlinesHIVTest08.pdf
Post testing
Page 11
The need for a repeat HIV test if still within the window period after a specific exposure should be discussed. Although fourth generation tests shorten the time from exposure to seroconversion a repeat test at three months is still recommended to definitively exclude HIV infection.
There are no tests marketed or sold that can give a conclusive test earlier than 3 months post exposure.
Its a shame that you never use information to back up your comments. The word unhelpful it more attributable to you as opposed to helpful.
Dr. Jose Gonzalez-Garcia, MD, MBBS, LMS, MRCP(UK), MRCGP, PhD
It is certainly quite unfortunate that you had contracted herpes type 2 in this unprotected sexual encounter. The negative test that you had at 8 weeks is certainly highly reassuring and a very good indication as it is possible to detect the HIV antibodies already at that stage. However current UK guidelines still recommend to have a final test at 12 weeks for it to be considered final and fully conclusive. Having said all that, and speaking out of my own clinical experience, I have never come across anyone testing negative at 8 weeks and then positive at 12 weeks. Therefore I am very confident that you are HIV negative.
Best wishes,
Dr José
It is certainly quite unfortunate that you had contracted herpes type 2 in this unprotected sexual encounter. The negative test that you had at 8 weeks is certainly highly reassuring and a very good indication as it is possible to detect the HIV antibodies already at that stage. However current UK guidelines still recommend to have a final test at 12 weeks for it to be considered final and fully conclusive. Having said all that, and speaking out of my own clinical experience, I have never come across anyone testing negative at 8 weeks and then positive at 12 weeks. Therefore I am very confident that you are HIV negative.
Best wishes,
Dr José
Well said and I totally agree.The DUO at 4 weeks is highly accurate at the rate of 99.89%.What you have to understand is that the UK and AUS have been using the DUO with great results for early detection but the USA has not.This is why UK and AUS Hiv specialist know alot more about the test and understand it's reliability.One of the best Hiv specialists in the world in melbourne,Australia said she thinks the DUO is an excellent test between 4 to 6 weeks and highly accurate.Her and her team were the first to discover where Hiv hides in the body,it was a major break through.Every single Hiv diagnosis in Australia last year was detected before 6 weeks.
Just did an antigen test and it was negative at 4 weeks.. I disagree with your statment about what i said being wrong. I suggest you read the following that comes from the UK health authorities...
I will get a standard antibody test at 3 months to rule out any possible infection. But a 1 month antigen test is an extemely good indicator that i do not have HIV.
Lesson learned. I will be more careful in future.
PLEASE READ BELOW
In the UK, even with dual antibody/antigen test, guidelines for many years stuck to the three-month window from exposure before testing. This was historical and in my personal opinion, out of date given the advances in the testing technology.
In March 2010, one of the professional associations involved in HIV testing – the British Association for Sexual Health and HIV (BASHH) – released updated guidelines, recognising that the vast majority of infections (over 95%) were likely to be detected after four weeks (ie by four weeks after the exposure). They also recommend a confirmation test three months later, and as i-Base are based in the UK, we want to provide consistent information, as long as this is supported by evidence. See below for the statement’s exact wording.
This change is welcomed. The current technology does not support any need for most people to have the stress of waiting an additional two months because of outdated guidelines. Unfortunately, we still hear of clinics that have still not changed their practice.
I understand that the reason for recommending the confirmatory test is two-fold:
i) A small number of people have individual responses to HIV that may not be picked up by the test at 28 days. When the tests are approved, this is based on a panel of responses from an extensive store of timed blood samples. These show that some samples pick up a positive test result after only a week and some after more than a month, but that most are positive for the p-24 antigen at around 15 days. Some people may not produce enough P-24 antigen for the test to pick this up though, so together with the antibody response, the combined test are still more than 95% accurate at four weeks.
ii) The second reason relates to the possibility that someone who is not picked up, might put another person at risk of HIV. This duty of care should be explained when you take the test the test and are given the results. So although you have almost certainly not caught HIV, you should use condoms with sexual partners, until the confirmatory result.
I wish there was an accurate test at two weeks or one day, but there isn’t. The technology is more complicated than most people realise, and the concern for future transmission of HIV, however slight the possibility, is a professional health care concern.
Please don’t let this cause you stress, you are almost certainly HIV-negative, but this is the detailed reason.
BASHH Statement on HIV window period
15 March 2010
HIV testing using the latest (4th generation) tests are recommended in the BHIVA/BASHH/BIS UK guidelines for HIV testing (2008). These assays [tests] test for HIV antibodies and p24 antigen simultaneously. They will detect the great majority of individuals who have been infected with HIV at one month (4 weeks) after specific exposure.
Patients attending for HIV testing who identify a specific risk occurring more that 4 weeks previously, should not be made to wait 3 months (12 weeks) before HIV testing. They should be offered a 4th generation laboratory HIV test and advised that a negative result at 4 weeks post exposure is very reassuring/highly likely to exclude HIV infection. An additional HIV test should be offered to all persons at 3 months (12 weeks) to definitively exclude HIV infection. Patients at lower risk may opt to wait until 3 months to avoid the need for HIV testing twice.
I will get a standard antibody test at 3 months to rule out any possible infection. But a 1 month antigen test is an extemely good indicator that i do not have HIV.
Lesson learned. I will be more careful in future.
PLEASE READ BELOW
In the UK, even with dual antibody/antigen test, guidelines for many years stuck to the three-month window from exposure before testing. This was historical and in my personal opinion, out of date given the advances in the testing technology.
In March 2010, one of the professional associations involved in HIV testing – the British Association for Sexual Health and HIV (BASHH) – released updated guidelines, recognising that the vast majority of infections (over 95%) were likely to be detected after four weeks (ie by four weeks after the exposure). They also recommend a confirmation test three months later, and as i-Base are based in the UK, we want to provide consistent information, as long as this is supported by evidence. See below for the statement’s exact wording.
This change is welcomed. The current technology does not support any need for most people to have the stress of waiting an additional two months because of outdated guidelines. Unfortunately, we still hear of clinics that have still not changed their practice.
I understand that the reason for recommending the confirmatory test is two-fold:
i) A small number of people have individual responses to HIV that may not be picked up by the test at 28 days. When the tests are approved, this is based on a panel of responses from an extensive store of timed blood samples. These show that some samples pick up a positive test result after only a week and some after more than a month, but that most are positive for the p-24 antigen at around 15 days. Some people may not produce enough P-24 antigen for the test to pick this up though, so together with the antibody response, the combined test are still more than 95% accurate at four weeks.
ii) The second reason relates to the possibility that someone who is not picked up, might put another person at risk of HIV. This duty of care should be explained when you take the test the test and are given the results. So although you have almost certainly not caught HIV, you should use condoms with sexual partners, until the confirmatory result.
I wish there was an accurate test at two weeks or one day, but there isn’t. The technology is more complicated than most people realise, and the concern for future transmission of HIV, however slight the possibility, is a professional health care concern.
Please don’t let this cause you stress, you are almost certainly HIV-negative, but this is the detailed reason.
BASHH Statement on HIV window period
15 March 2010
HIV testing using the latest (4th generation) tests are recommended in the BHIVA/BASHH/BIS UK guidelines for HIV testing (2008). These assays [tests] test for HIV antibodies and p24 antigen simultaneously. They will detect the great majority of individuals who have been infected with HIV at one month (4 weeks) after specific exposure.
Patients attending for HIV testing who identify a specific risk occurring more that 4 weeks previously, should not be made to wait 3 months (12 weeks) before HIV testing. They should be offered a 4th generation laboratory HIV test and advised that a negative result at 4 weeks post exposure is very reassuring/highly likely to exclude HIV infection. An additional HIV test should be offered to all persons at 3 months (12 weeks) to definitively exclude HIV infection. Patients at lower risk may opt to wait until 3 months to avoid the need for HIV testing twice.
Sorry, i thought (according to uk health experts) that a standard antibody test at 6 weeks was conclusive by 99% and at 3 weeks 90%! also, they told me that a DUO test at 4 weeks is 100% definitive.. Why does everyone keep stating about this 3 month thing. They told me at the doctors that this view is outdated and should be changed.
I will go get duo test monday and post result. Thanks for your assistence. i appreciate
I will go get duo test monday and post result. Thanks for your assistence. i appreciate
You need to get your conclusive negative test 3 months post exposure, don't worry about hunting for a place that has the duo test because most places don't offer it any antibody test will do.
OK,best plan of action.Take a DUO test at 4 weeks and then a final antibody test at 12 weeks.All the best.
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